04 April 2011

Turn on your wayback machines, and dial them back to the summer of 2009, a wild and crazy time when Ugg boots and "Epic Fail" were fresh and hip trends. The US Congress adjourned for the season and went home to an unanticipated frenzy in their districts, as enraged citizens mobbed their townhall meetings to rant against nonexistent death panels, demand that government stay out of their medicare, and decry government-run health care as the greatest affront to personal liberty since, I dunno, the minimum wage or internment camps or something. It didn't make much sense at the time, and makes less sense when view through the filter of posterity, 21 months later.

Anywho, here we are in the dystopian future under ObamaCare and surely as FreedomWorks predicted, we are seeing unprecedented infringements on individuals' autonomy with regard to healthcare and lifestyle choices. Did you know that the federal government is now going to be attaching a special healthcare tax (or penalty or fine or or "premium adjustment" or whatever euphemism for a tax you choose to use) on people who choose to disregard the orders of their assigned healthcare provider? Yes! If your doctor says you should stop smoking, and you don't, or if your doctor suggest that you're getting a little chubby and maybe you should lose some weight, then Obama will levy a fine on you for refusing to kowtow to the PC wisdom of the day. Yes, you read that right: you will be taxed for being fat, and you will be taxed for smoking if the government in its paternalistic wisdom decides that you should not. Next thing they will want to put a special tax on soda pop and sugary drinks!

If that isn't an governmental intrusion into the personal liberty of private citizens, then I don't know what is.

Oh, wait, did I say it was Obama and the federal government? Sorry, that was a typo. Or a pun. Possibly an anagram. My bad. In fact, it's the republican governor of Arizona who is advocating these new rules, and they only apply to poor people. So all that about "individual liberty" and "freedom of choice" and all that -- you know, never mind. "Personal responsibility" or something. It's only an affront to liberty when it's proposed by a Democrat, or when it applies to people who matter with money.

9 comments:

Clever. Of course, Arizona Health Care Cost Containment System (AHCCCS, pronounced "access," which is AZ's medicaid plan) beneficiaries who don't like this "assessment" are free to seek health coverage elsewhere, just as I would be free to leave BCBS if they imposed a similar surcharge on me. So like it or not, it's optional.

On the other hand, if the federal government became the sole source of required health care coverage, we'd have no options if they decided to impose a similar assessment.

You don't like the rules? Pay your own bills, same as I taught my teenagers a decade ago.

But, I am libertarian enough to believe that if ALL third parties got out of health care that the market would self-adjust. In the meantime, I prefer NOT to have my confiscated tax dollars used fund expensive medical interventions when losing 75 pounds and giving up booze and ciggies would "cure" the illness.

PJ,Guess what. "Health plans" exist to make money. The point of business is to try and not pay out if at all possible. Sweetie, it doesn't matter who starts with penalties. All plans public or private will follow. It is ONLY about the money honey. It is not about keeping you healthy.

It probably would have been better if this had been proposed at a discount or a payment to those that do quit smoking or slim down. That's what they do at Middle to Lower Class Suburban Medical Center where you practice. That's what numerous other employers and health systems do, that's what even the much admired NHS in the UK does. It is exactly the same thing, a penalty for not following instructions or a discount or bonus for following them.

This is mainly a PR problem, Governor Brewer is really bad at PR. If this were describes as a $50 a year discount for patients that make good health decisions instead of a $50 a year penalty for those that make bad decisions, it would have support from everyone except those that will condemn anything someone with an "R" after their name does, even while praising the guy with the "D" for doing the same thing.

50 bucks is less than 2 months of cigarettes for the average smoker. Hard to feel too much sympathy with all the options/help quitting As for the obesity, that does seem a bit unfair. As for the diabetes, it'd be better if they tracked A1C, but again, provided the levels weren't unreasonably low, it might be an effective incentive.

As for why this isn't a discount, these people likely don't pay for their health coverage, so you can't really give a discount unless you want to hand out money/drive the program further in debt (at least in the short term, before the health benefits are realized).

Oh I should add, the thing I don't like about the law is that is sounds like that, if you don't pay the 50 bucks, they just cut you off. Seems like a bad idea as many of those affected might not be making the best decisions. It's really hard for a single adult to get medicaid (the only ones this law would affect). Some of these people have some degree of mental illness (in fact schizophrenics smoke waaay more than average).

I think it would be better if they at least gave the option to take it out of someone's state tax returns (the people who qualify for medicaid will usually get 100% of their state taxes returned and in some cases even get additional refunds). The state still gets their 50 bucks, but someone doesn't have to cough it up directly, and there is no danger of someone losing coverage.

I would also propose the above as a method of collecting ER copays for non-emergencies (provided you could change the relevant national laws). It would largely eliminate the argument that "people won't go to the ER for something major as they don't have money" yet still has the potential to reduce abuse.

Liberals are unbelievable. Shadowfax is complaining that the government is putting regulations on the people that are living on the government. If the government is providing funding for these poor, fat, smoking, slobs shouldn't they be enabled to enact cost controls on these people? Of course they can, but these poor slobs can choose to end their learned helplessness and seek other coverage. WHAT? You mean they don't HAVE to live off the government and MY tax dollars? Blasphemy! Everyone knows that the Nanny state is the only way to go.

It is things like this that make capitalism the great thing that it is. Having a free market to seek other insurance options is truly a wonderful thing. Or to not seek an option at all. Oh, wait, no, Obamacare won't allow that. So we go back to Shadowfax complaining about government regulations, yet he's supporting the government regulation of the individual mandate in Obamacare. Typical liberal circular logic. They need the government to justify their existence.

Shadowfax

About me: I am an ER physician and administrator living in the Pacific Northwest. I live with my wife and four kids. Various other interests include Shorin-ryu karate, general aviation, Irish music, Apple computers, and progressive politics. My kids do their best to ensure that I have little time to pursue these hobbies.

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